Functional recovery after peripheral nerve injury and implantation of a collagen guide.
Although surgery techniques improved over the years, the clinical results of peripheral nerve repair remain unsatisfactory. In the present study, we compare the results of a collagen nerve guide conduit to the standard clinical procedure of nerve autografting to promote repair of transected peripheral nerves. We assessed behavioral and functional sensori-motor recovery in a rat model of peroneal nerve transection. A 1cm segment of the peroneal nerve innervating the Tibialis anterior muscle was removed and immediately replaced by a new biodegradable nerve guide fabricated from highly purified type I+III collagens derived from porcine skin. Four groups of animals were included: control animals (C, n=12), transected animals grafted with either an autologous nerve graft (Gold Standard; GS, n=12) or a collagen tube filled with an acellular skeletal muscle matrix (Tube-Muscle; TM, n=12) or an empty collagen tube (Collagen-Tube; CT, n=12). We observed that 1) the locomotor recovery pattern, analyzed with kinetic parameters and peroneal functional index, was superior in the GS and CT groups; 2) a muscle contraction was obtained in all groups after stimulation of the proximal nerve but the mechanical muscle properties (twitch and tetanus threshold) parameters indicated a fast to slow fiber transition in all operated groups; 3) the muscular atrophy was greater in animals from TM group; 4) the metabosensitive afferent responses to electrically induced fatigue and to two chemical agents (KCl and lactic acid) was altered in GS, CT and TM groups; 5) the empty collagen tube supported motor axonal regeneration. Altogether, these data indicate that motor axonal regeneration and locomotor recovery can be obtained with the insertion of the collagen tube RevolNerv. Future studies may include engineered conduits that mimic as closely as possible the internal organization of uninjured nerve.
Alluin
Olivier
O
UMR CNRS 6233, Institut des Sciences du Mouvement: Etienne-Jules MAREY, Equipe Plasticité des Systèmes Nerveux et Musculaires, Université de la Méditerranée (Aix-Marseille II), 13288 Marseille Cedex 09, France.
Wittmann
Catherine
C
Marqueste
Tanguy
T
Chabas
Jean-François
JF
Garcia
Stéphane
S
Lavaut
Marie-Noëlle
MN
Guinard
Didier
D
Feron
François
F
Decherchi
Patrick
P
D000344:Afferent Pathways / Q000187:drug effects; D000818:Animals; D001369:Axons / Q000187:drug effects / Q000378:metabolism; D003094:Collagen / Q000378:metabolism*; D004560:Electricity; D006614:Hindlimb / Q000503:physiopathology; D020007:Implants, Experimental; D007267:Injections; D019344:Lactic Acid / Q000008:administration & dosage / Q000494:pharmacology; D008124:Locomotion / Q000187:drug effects; D008297:Male; D018763:Muscle Fatigue / Q000187:drug effects; D009133:Muscular Atrophy / Q000473:pathology; D059348:Peripheral Nerve Injuries; D010525:Peripheral Nerves / Q000473:pathology / Q000503:physiopathology* / Q000601:surgery; D010543:Peroneal Nerve / Q000187:drug effects; D011189:Potassium Chloride / Q000008:administration & dosage / Q000494:pharmacology; D019919:Prosthesis Implantation; D051381:Rats; D017207:Rats, Sprague-Dawley; D020127:Recovery of Function / Q000187:drug effects / Q000502:physiology*; D013742:Tetanus
D019344:Lactic Acid; D011189:Potassium Chloride; D003094:Collagen